Q&A: What should women do to keep their bones healthy?

UNIVERSITY PARK, Pa. — One in 10 Americans experience osteoporosis, which significantly weakens bones and makes them more prone to fracture. Women comprise 80% of people with osteoporosis, and women approaching or in menopause are at the highest risk, according to Mary Jane De Souza, distinguished professor of kinesiology and physiology. De Souza explained that May serves as both Osteoporosis Awareness Month and Women’s Health Month, making it the ideal time for both women and men to learn how to maintain healthy bones for as long as possible.

Women officially enter menopause one year after their final menstrual cycle, but the transitional process typically lasts for years. In menopause, the body produces far less estrogen, which is essential for women’s bone health. In the decade following menopause, women can lose one-fifth of their bone mass, De Souza said.

Bone loss can lead to fractures that reduce mobility, decrease quality of life and result in the loss of independence. De Souza noted that 25% of women who have a hip fracture never return to their full functional life, and 20% die from problems associated with being immobilized — including pneumonia and blood clots.

De Souza is currently leading a United States Department of Agriculture-funded study to determine whether the regular consumption of prunes can slow or prevent the significant bone loss women experience during the transition to menopause.

In this Q&A, De Souza discussed ways to maintain bone health that not only benefit older women, but people of all ages.

Q: Why should aging women be concerned about bone health?

De Souza: Women can’t just sit back and let bone loss happen. Osteoporosis is a difficult condition to manage, and we need to be proactive.

Post-menopausal women lose about 1% to 2% of their bone mass every year, and some women can lose bone even faster. If, for example, your parents or grandparents lost height or showed other evidence of osteoporosis, then your rate of bone loss could be higher.

The year before a woman is officially in menopause and the first two years of menopause are a critical period for bone health. During these three years, women typically experience more rapid bone loss than at any other point in their life, losing as much as 10% of their bone mass.

What’s upsetting is that there are currently no clinical prevention protocols in place for this dramatic and nearly universal bone loss among women. Prevention is a woman’s best bet at maintaining healthy bones for a long life, and we believe that prunes might help prevent that dramatic volume of bone loss during the menopause transition.

The terminology — perimenopause, menopause, postmenopause — may get confusing sometimes, but the fundamental message is simple: Women near or in menopause need to work to preserve their bone health.

Q: How is bone loss treated?

De Souza: Calcium and vitamin D are important for maintaining bone health, but they cannot offset the losses that women experience after menopause. Bone health has to be diligently measured to prevent loss.

There are pharmacological therapies — medications — that can treat bone loss effectively, but they are typically only prescribed when women have already experienced a lot of bone loss. They also have side effects and cannot be taken without some caution. After a while, you have to quit taking the medications — take a drug holiday — for a few years.

Q: How do prunes help prevent bone loss?

De Souza: Prunes work by decreasing inflammation, and inflammation is at the root of many diseases. So, prune consumption may be healthy in ways that are not even related to bones.

It is generally healthier, easier and cheaper to prevent a health problem than it is to treat it. I was excited about the possibility of how a natural, whole food might work as a drug-free preventive treatment.

My previous prune study showed that postmenopausal women who ate a handful of prunes every day for a year did not lose any bone, and some of their internal bone structures actually improved.

Since that was successful, my research team turned our attention to women in the three years surrounding the menopause transition because that is when women experience the most bone loss. Can we cut the loss rate to 5% or even 3%? If so, that might keep millions of women active and healthier later in their lives.

Our current $1.49 million grant from the United States Department of Agriculture’s National Institute of Food and Agriculture will provide women in perimenopause — roughly the decade before menopause — with five or six prunes each day for 18 months to see if we can stop this catastrophic bone loss. The study is launching now, so we will not have results for some time, but I am hopeful.

Q: What should people do to preserve bone health?

De Souza: Even though men maintain bone strength in their 70s and beyond while women usually begin to lose that strength in their mid-50s, the same advice applies to all people. We all need to eat a bone-healthy diet featuring calcium-rich foods like low-fat yogurts and milks.

Also, everyone needs vitamin D to absorb the calcium they consume. Vitamin D is available through sunlight, but some people need supplements if they avoid sunlight due to skin cancer risk or other reasons.

Exercises that place load on your bones are also critically important. This can include activities like running, jumping and weightlifting or low-impact exercises like walking, tennis and dancing — depending on your current fitness and activity level. Activities like these help to maintain muscle mass and bone mass.

The same advice applies to younger people as well. Diet and exercise are keys to health overall and bone health in particular. The best chance anyone has of staying healthy is to get regular medical checkups, stay active, maintain muscle mass, get enough sleep and be happy!